• Archives of Plastic Surgery
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• 제42권3호
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• pp.334-340
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• 2015

Background Full-thickness skin grafts (FTSGs) are generally considered unreliable for coverage of full-thickness finger defects with bone or tendon exposure, and there are few clinical reports of its use in this context. However, animal studies have shown that an FTSG can survive over an avascular area ranging up to 12 mm in diameter. In our experience, the width of the exposed bones or tendons in full-thickness finger defects is <7 mm. Therefore, we covered the bone- or tendon-exposed defects of 16 fingers of 10 patients with FTSGs. Methods The surgical objectives were healthy granulation tissue formation in the wound bed, marginal de-epithelization of the normal skin surrounding the defect, preservation of the subdermal plexus of the central graft, and partial excision of the dermis along the graft margin. The donor site was the mastoid for small defects and the groin for large defects. Results Most of the grafts (15 of 16 fingers) survived without significant surgical complications and achieved satisfactory functional and aesthetic results. Minor complications included partial graft loss in one patient, a minimal extension deformity in two patients, a depression deformity in one patient, and mild hyperpigmentation in four patients. Conclusions We observed excellent graft survival with this method with no additional surgical injury of the normal finger, satisfactory functional and aesthetic outcomes, and no need for secondary debulking procedures. Potential disadvantages include an insufficient volume of soft tissue and graft hyperpigmentation. Therefore, FTSGs may be an option for treatment of full-thickness finger defects with bone or tendon exposure.

• Archives of Reconstructive Microsurgery
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• 제23권2호
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• pp.65-69
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• 2014

Purpose: Soft tissue reconstruction is essential for recovery of finger function and aesthetics in any traumatic defect. The authors applied a reverse homodigital artery island flap for soft tissue defect on distal part of digits. The aim of this study is to evaluate the efficacy of the procedure. Materials and Methods: Seven cases of soft tissue defects of finger tip were included in this study. There were six male and one female, mean age was 43 years and mean follow-up period was 38 months. The length of flaps ranged from 2.0 to 2.5 cm and width ranged from 1.0 to 2.0 cm. Flap survival, postoperative complications were evaluated. Results: All flaps survived without loss. Donor sites were repaired with primary closure in five cases and skin graft in two cases. None of the patients showed significant complications and their average finger motion was $255^{\circ}$ in total active motion at the last follow-up. Conclusion: The authors suggest that the reverse homodigital artery island flap could be a versatile treatment option for the soft tissue defect on distal part of digits.

• Archives of Plastic Surgery
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• 제49권6호
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• pp.745-749
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• 2022

Background Soft tissue defects of the multiple finger present challenges to reconstruction surgeons. Here, we introduce the use of a lateral arm free flap and syndactylization for the coverage of multiple finger soft tissue defects. Methods This retrospective study was conducted based on reviews of the medical records of 13 patients with multiple soft tissue defects of fingers (n = 33) that underwent temporary syndactylization with a microvascular lateral arm flap for temporary syndactylization from January 2010 to December 2020. Surgical and functional outcomes, times of flap division, complications, and demographic data were analyzed. Results Middle fingers were most frequently affected, followed by ring and index fingers. Mean patient age was 43.58 years. The 13 patients had suffered 10 traumas, 2 thermal burns, and 1 scar contracture. Release of temporary syndactyly was performed 3 to 9 weeks after syndactylization. All flaps survived, but partial necrosis occurred in one patient, who required a local transposition flap after syndactylization release. The mean follow-up was 15.8 months. Conclusion Coverage of multiple finger defects by temporary syndactylization using a free lateral arm flap with subsequent division offers an alternative treatment option.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2002년도 ICCAS
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• pp.77.5-77
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• 2002

A mechanical device was developed for assisting the grasping function of a person whose fingers suffered cervical injury and thus are unable to grasp. This device is composed of a mechanical glove put on the user's hand and a muscle sensor to measure the activity of his or her muscle. The mechanical glove consists of a finger frame, a base and an air cylinder mounted on the base. With the kinematics carefully designed, the finger frame can achieve the grasping motion under the actuation of the air cylinder. For controlling this motion, an innovative sensor was developed to detect the user's motion intention. The sensor measures the change of the muscle stiffness...

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.7-11
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• 2001

Purpose : To evaluate the neurologic abnormalities in the donor limb after contralateral C7 transfer in brachial plexus injury. Materials and Methods : From August 1996 to December 1999, five patients with brachial plexus injury were treated with contralateral C7 nerve root transfer. The average follow up was 16 months(range, 5 to 36 months). The clinical findings were assessed using the British Medical Research Council Grading System, and also measured grip power, pinch power of hand and two point discrimination of the fingers. Results : We had no difference in shoulder abduction and elbow flexion after contralateral C7 transfer. The grip and pinch strength were recovered within 4weeks. Sensory loss occurred in all patients and was noted to be more severe on index and middle finger. Four patients recovered within 2 weeks, one continued till one year. Subjective numbness and pain on percussion minimally persisted until last follow-up. Conclusion : The division of the C7 nerve root resulted in minimal and temporary functional deficit in the donor upper limb.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.153-158
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• 2018

Posterior interosseus (PI) nerve compression is a rare form of compressive neuropathy. It can cause pain along the radial nerve course and weakness of radial nerve innervating muscles without sensory symptoms. A 65-year-old man visited our institution complaining weakness of finger extension and thumb abduction after 2 times of injections at the right elbow in local clinic. The patient's clinical history and physical examination implied an iatrogenic radial nerve injury caused by the injection. The electrophysiologic study revealed of posterior interosseus neuropathy (PIN) with incomplete conduction block. However, the ultrasound study showed that the PI nerve was compressed by an anechoic cyst. The magnetic resonance imaging also confirmed of a ganglion cyst, not a hematoma. After repeated aspirations and a steroid injection, the electrophysiologic study showed recovery of motor weakness. Despite of the clue which implying an iatrogenic injury, clinician should consider other possibilities such as ganglion cysts and ultrasound guided aspiration and steroid injection could be an effective option for conservative management.

• 대한물리치료과학회지
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• 제10권2호
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• pp.246-257
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• 2003

Even though the automation of industrial machinery has dramatically increased, most industries still require human hands for the production of goods. Our hands are essential to our existence. For this reason, hand injuries caused by industrial accidents have become an important issue lately. Most hand injuries are external wounds and constitute 38.6% of disabling industrial accidents. This significant statistic cannot be ignored by rehabilitation programs. The rate of success in operations of finger and hand injuries has increased, but relatively less consideration has been given to physical therapy, rehabilitation, research, or systematic installment in terms of welfare, which would help the injured carry on the nominal life they lived before their injury. Therefore, it is necessary to study systematically all related aspects to provide patients with physical therapy, rehabilitation, and social welfare, in order to restore their social, professional, and economical capabilities. Physical considerations, functional usability, and cosmetic restoration, as well as the patients' mental state must be addressed. The results of the study shows several problems. Medical appliances, manpower, and the environment of the treatment rooms are very poor. The patients cannot receive treatment early enough nor enough treatment because of too many patients for too few physical therapists. Close cooperation between physical therapists and doctors, nurses, or related departments is lacking. Furthermore, it is irrational that industrial accident premiums for the exert; e treatment of hand injury patients are not itemized. Lack of recognition of the importance of specialty in hand injury therapists leads to the lack of professionalization of systematic hand injury treatment In order to solve these problems, the professonalism of physical therapy should be acknowledged and particular treatment courses should be available and/or required. Based on the understanding of the hand injury patients' needs, new theories of physical therapy should be developed and modem medical appliances and facilities should be available, in order to provide the patients with qualitative medical treatment, which then will facilitate the patients' recovery.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.113-116
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• 2011

Purpose: Many fingertip injuries are associated with nail injury and it is hard to repair to original shape due to its unique characteristic. Mucosal graft is used for a defect of the nail bed injury. Hereby, we introduce a DAP flap and buccal mucosal graft, with which we could reduce the defect size of the injured fingertip and donor site morbidity at the same time, without any need for harvesting additional skin from other part of hand. Also, mucosal graft makes good cosmetic and functional outcome of nail. Methods: This method was performed in a 56-year-old man with fingertip injury on dorsal side of left thumb due to electrical saw. First, DAP flap was performed on the injured finger to reduce the size of the defect of fingertip and cover the bone exposure. Second, nail bed part of the DAP flap was de-epithelized and buccal mucosal graft was done from left side of intraoral cavity wall. Results: Flap and graft survived without any necrosis but some nail bed could not be covered with flap due to insufficient flap size. All wounds healed well and did not present any severe adversary symptoms. Conclusion: DAP flap with mucosal graft is an effective method that we can easily apply in reconstruction of fingertip injury. We suggest that the combination of the two procedures makes good functional and cosmetic outcome compared to the usual manner, especially in cases of nail bed injury without distal phalanx bone defect.

• 대한정형외과스포츠의학회지
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• 제8권1호
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• pp.51-55
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• 2009

수지 근위 지관절의 전방 회전 탈구는 매우 드물게 발생한다. 저자들은 여자 유도 선수에서 발생한 수지 근위 지관절의 전방회전 탈구를 경험하였기에 이를 문헌고찰과 함께 보고하고자 한다. 24세 여자 유도 선수로 총 4번의 근위 지관절 전방 탈구가 발생하였다. 수술 시 회전 손상으로 파열된 척측 측부 인대와 파열 없이 늘어져 있는 중앙 건을 확인할 수 있었다. 수술적 치료로 파열된 척측 측부 인대 봉합술과 중앙 건과 측부대 사이를 봉합하여 근위 지관절의 배측부를 강화 시켜주었다. 술 후 운동시에 탈구는 다시 발생하지 않았다. 수지 근위 지관절의 전방 회전 탈구는 매우 드문 손상이지만 다른 탈구처럼 조기 진단과 치료, 그리고 단계적인 재활이 무엇보다 중요하겠다.

• Archives of Reconstructive Microsurgery
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• 제18권1호
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• pp.27-30
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• 2009

Purpose: Recently, replantation of fingertip amputation, Zone I by Yamano classification, is still difficult because digital arteries branch into small arteries and also digital veins are hard to separate from the immobile soft tissue. However the replantation of fingertip in adults is a well-established procedure, but the replantation in infant or child is still uncommon. Therefore we present one case of replantation of the fingertip of the small finger in 12-months-old patient. Methods: We experienced a 12-months-old male amputation of small finger. It had been amputated completely at the level of Zone I by Yamano classification. Replantation was performed using the arteryonly technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration. Venous drainage was provided by an external bleeding method with partial nail excision and repaired margin for approximately 7 days. Results: We were performed replantation in infant with only-arterial anastomosis successfully, result in good recovery of aesthetic and functional outcome. Conclusion: In conclusion, although fingertip injury was difficult to replantation in infant and child, we must try it. Because of its functional and cosmetic advantage.